Job Description
Job DescriptionSalary:
Rapid City Medical Center is seeking a full-time Insurance Specialist to join our team. In this role, you will manage all aspects of healthcare claim denials and accounts receivable, ensuring timely and accurate submission of claims in compliance with payer and organizational policies.
The ideal candidate will be detail-oriented and proactive, with a strong understanding of billing procedures and healthcare reimbursement. Responsibilities include supporting payer audits, identifying trends in claim processing, and staying current with billing regulations and procedures. The ability to work both independently and collaboratively in a team environment is essential.
Enjoy a great work-life balance no nights, weekends, or holidays!
Who We Are
Rapid City Medical Center is a physician clinic dedicated to excellence, choice, and patient-centered care. We prioritize building strong relationships with our patients, partnering with them throughout their health journey. Our team of 90 physicians and advanced practice providers, supported by over 400 employees, combines leading-edge technology with medical expertise to ensure efficient and effective appointments and smooth insurance interactions.
We thrive on collaborating with smart, compassionate individuals. Our work can be challenging, but we are motivated by serving our families, friends, and community in meaningful ways. We value work-life balance and career satisfaction, offering competitive wages, exceptional benefits, and a workplace where you can feel proud of your contributions.
Our benefits package includes health, dental, and vision insurance, 401(k) with profit sharing, life insurance, short- and long-term disability coverage, seven paid holidays plus a floating birthday, paid time off (PTO), and flexible scheduling to support important personal and family milestones.
ESSENTIAL FUNCTIONS:
- Responsible for insurance accounts receivable
- Follow up on unpaid claims utilizing the established workflows
- Responsible to ensure claims are worked in the proper manner
- Ensure all corrected claims and appeals are completed correctly and in a timely manner
- Assist in payor audits by collecting, reviewing, and collaborating with multiple departments to submit information and responses in a timely manner
- Responsible to review updates and policy changes communicated by payors via newsletter or other correspondence
- Communicate identified trends to varying levels of leadership
- Collaborate with multiple departments to resolve identified trends and workflow improvements
- Maintains patient confidentiality
- Performs other duties as assigned
EDUCATION:
High school degree or equivalent. Must be 18 years or older.
EXPERIENCE: Minimum of one year of experience in a billing office working with claims submissions to insurance companies. Preferred experience in working with insurance companies regarding insurance claims and denials.
KNOWLEDGE:
- Knowledge of medical terminology, medical billing, insurance claims processing, and collection practices
- Read and interpret an Explanation of Benefits (EOB)
- Knowledge of a practice management and EMR system, eClinicalWorks preferred
- Microsoft Office
SKILLS, AND ABILITIES:
- Ability to multi-task and work under pressure in a deadline driven environment with changing priorities.
- Ability to communicate clearly in person, in writing, and on the phone to establish/maintain cooperative relationship with patients, families, physicians, staff and other customers.
- Strong organizational and problem-solving skills.
- Strong customer service skills.
- Basic knowledge of Microsoft Word and Excel.
- Skill in using web-based healthcare coding programs and systems.
- Ability to examine insurance documents to ensure accuracy and completeness.
- Ability to prepare insurance records in accordance with detailed instructions.
ENVIRONMENTAL/WORKING CONDITIONS:
- Work is performed in an office environment.
- Frequent contact with employees.
- Frequent interruptions.
- Minimal exposure to communicable diseases.
PHYSICIAL AND ENVIRONMENTAL WORKING CONDITIONS
- Job requires largely sedentary role requiring ones ability to sit for extended period of time.
- Ability to occasionally lift and/or move up to 10 pounds.
- Must be able to talk, listen and speak clearly on telephone
- Manual dexterity for using a computer keyboard.
This job description is intended to describe the essential job functions of this position and is not intended to be an all-inclusive statement of job responsibilities.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or veteran status.